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<blockquote data-quote="martinbuchan" data-source="post: 1048" data-attributes="member: 718"><p>Patti- I am a simple orthopaedic surgeon so I knew naf all about the real day to day management of diabetes. If I had a patient in DKA or severe hypo- then I would have sorted it out properly. </p><p></p><p>At the moment I have an osteomyelitic bone infection in my foot- I have to push the system to get what I need (about to start hyperbaric oxygen therapy at my local NHS supported decompression diving chamber). Luckily I can give myself my own intravenous antibiotics at home. </p><p></p><p>It is well accepted that patients only recall about one third of a consultation. The new members here have a hell of a job getting to grips with it. I am not a good example as it is a lot easier for me to absorb all the new skills. I can't carb count as my glucose profile has not been static since diagosis one year ago. I usually dose adjust appropriately- mind you I have had mild hypos over the last three evenings. My last HBA1C was 6.5% (I don't know what this weeks one was yet). You have a fab HBA1C- you sound like my paediatrician neighbour who ranges 4.9%-5.6%. You have a lot to teach insulin users. </p><p></p><p>We all have differnet profiles. I have to keep my HBA1C low as I have neuropathy. I also need to closely monitor my post prandial BG which is a different ball game in type 2 compared to type 1. In type 2, the liver produces 3 times more glucose (gluconeogenesis) than normal subjects. It is not just an insulin resistance/underproduction issue. I use my basal/bolus regime in a differnt way to my type 1 neighbour although we both use a n a loque insulins.</p><p></p><p>Most diabetics are type 2 and most of them are not young. I suppose this forum will be biased towards type 2 users. Also, most type 2s are not unwell at diagnosis or in childhood. So a lot of new forum users will be diagnosed by GPs and treated in surgeries rather than in hospital specialised clinics. </p><p></p><p>This is the new labour NHS ethos. Patients defining their treatment and care. Scary as we already advise doctors not to treat themselves. How the hell are normal punters supposed to do it without a medical degree and years of experience of medicine behind them?</p><p></p><p></p><p>I hope you continue to contribute as you have a lot of experience and success. Your advice will not be relevent to everybody but that is just fine.</p><p></p><p></p><p>Marty B</p></blockquote><p></p>
[QUOTE="martinbuchan, post: 1048, member: 718"] Patti- I am a simple orthopaedic surgeon so I knew naf all about the real day to day management of diabetes. If I had a patient in DKA or severe hypo- then I would have sorted it out properly. At the moment I have an osteomyelitic bone infection in my foot- I have to push the system to get what I need (about to start hyperbaric oxygen therapy at my local NHS supported decompression diving chamber). Luckily I can give myself my own intravenous antibiotics at home. It is well accepted that patients only recall about one third of a consultation. The new members here have a hell of a job getting to grips with it. I am not a good example as it is a lot easier for me to absorb all the new skills. I can't carb count as my glucose profile has not been static since diagosis one year ago. I usually dose adjust appropriately- mind you I have had mild hypos over the last three evenings. My last HBA1C was 6.5% (I don't know what this weeks one was yet). You have a fab HBA1C- you sound like my paediatrician neighbour who ranges 4.9%-5.6%. You have a lot to teach insulin users. We all have differnet profiles. I have to keep my HBA1C low as I have neuropathy. I also need to closely monitor my post prandial BG which is a different ball game in type 2 compared to type 1. In type 2, the liver produces 3 times more glucose (gluconeogenesis) than normal subjects. It is not just an insulin resistance/underproduction issue. I use my basal/bolus regime in a differnt way to my type 1 neighbour although we both use a n a loque insulins. Most diabetics are type 2 and most of them are not young. I suppose this forum will be biased towards type 2 users. Also, most type 2s are not unwell at diagnosis or in childhood. So a lot of new forum users will be diagnosed by GPs and treated in surgeries rather than in hospital specialised clinics. This is the new labour NHS ethos. Patients defining their treatment and care. Scary as we already advise doctors not to treat themselves. How the hell are normal punters supposed to do it without a medical degree and years of experience of medicine behind them? I hope you continue to contribute as you have a lot of experience and success. Your advice will not be relevent to everybody but that is just fine. Marty B [/QUOTE]
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